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Testing and treatment for malaria elimination: a systematic review
Gretchen Newby1, Chris Cotter1,2, Michelle E Roh1,3
1Malaria Elimination Initiative, Institute for Global Health Sciences, University of California San Francisco (UCSF), 550 16th Street, San Francisco, CA, 94143, USA.
Malaria Journal
|September 3, 2023
Summary
Proactive mass test and treat (MTaT) strategies show weak impact on malaria transmission. Reactive case detection (RACD) improves infection detection, potentially aiding malaria elimination efforts.
Area of Science:
- Malariology
- Epidemiology
- Public Health
Background:
- Global malaria elimination goals drive research into active test and treat (TaT) strategies.
- Investigating the efficacy of TaT in reducing malaria transmission is crucial for public health initiatives.
Approach:
- A systematic review and meta-analysis synthesized evidence from 72 empirical and 24 modeling studies.
- Evaluated proactive mass test and treat (MTaT) and reactive case detection (RACD) strategies in various transmission settings.
Key Points:
- Evidence for MTaT's impact on malaria incidence was weak, with ten intervention studies showing limited effect.
- Reactive case detection (RACD) combined with passive case detection (PCD) significantly increased infection detection by 52.7% (low transmission) and 11.3% (very low transmission) using standard diagnostics.
- Molecular methods further enhanced infection detection by 1.4-fold (low) and 1.1-fold (very low) transmission settings.
Conclusions:
- Proactive mass test and treat (MTaT) is not effective for reducing malaria transmission.
- Reactive case detection (RACD) can indirectly reduce transmission by improving surveillance and informing targeted interventions.
